|
    
| |
Case 24
Primary Clinicians: Darcy Adin, DVM
& Chris Adin, DVM
Supervising Clinician: Mark D. Kittleson,
DVM, PhD,
DipACVIM (Cardiology)
Signalment
 | Six-year-old neutered male Doberman Pinscher ("Nitro") |
Presenting Complaints
| Vomiting |
Pertinent History
| Nitro was treated for pancreatitis by the referring DVM last week. He
received fluids and Baytril. He recovered and was getting better when he started
vomiting the last few days. |
| The owner thinks that maybe he introduced the
regular dog food too soon and should have kept him on cottage cheese and rice
longer. |
| Yesterday he began vomiting more and became very lethargic. He was taken
to the referring DVM. Because the heart sounds were muffled, chest x-rays were
taken which showed an enlarged cardiac silhouette. |
| The referring DVM gave him 1L
Lactated Ringer's Solution IV and Nitro improved although he still appeared
slightly shocky. |
| He was referred to the VMTH. |
| Blood work was done last week. The owner said the white cell count was
elevated and the liver enzymes showed evidence of toxicity. |
Physical Examination
| General: QAR, moderately dehydrated, presents in sternal recumbency,
reluctant/unable to stand. |
| HR=200, RR= 30 |
| Integument: Full coat, somewhat dry. No cutaneous masses. |
| EENT: Eyes--clear, Ears--clean, tonsils in crypts. |
| Musculature: well muscled, BCS 6/9 |
| Cardiovascular: Mm pale; muffled heart sounds; pulses decrease on
inspiration and increase on expiration; no murmur ausculted; rhythm is
regular but tachycardic; jugular vein distension noted. |
| Respiratory: lungs clear in all fields |
| GI/GU: no ascites appreciated; smooth gut loops; no palpable masses. Kidneys/bladder not palpable. |
| No peripheral lymphadenopathy. |
Problems
| Abnormal pulses |
| Muffled heart sounds |
| Jugular vein distension |
| Tachycardia |
| 2-3/6 systolic heart murmur |
Quiz
Correct Quiz
 |
